The Social Security Administration (SSA) updated the disability criteria for evaluating hearing loss, effective August 2, 2010. The Academy commented on the proposed rule and several of those recommendations were incorporated in the final rule. Of interest to audiologists are the following components:

Audiometric testing must be performed by or under the direct supervision of a qualified audiologist or otolaryngologist

A qualified audiologist is determined by state or U.S. territory licensure or registration. If none exists, current certification by the American Board of Audiology (ABA) or the Certificate of Clinical Competence (CCC-A) is required.

Consistent with Medicare policy, non-audiologists are required to be directly supervised (present in the facility) by a physician, including hearing instrument specialists who were not recognized as independent providers

Children with cochlear implants are considered disabled until age 5 or one-year post implantation, the latter of the two events

Word recognition testing is required after the age of 5 and must be an “age-appropriate” version of the Hearing in Noise Test (HINT) or the HINT-C, for children with cochlear implants

Others with cochlear implants will be considered disabled until 1 year, post implantation

An audiometric test should be completed prior or following a complete otologic evaluation. The previous criteria required an otologic exam to be completed up to 2 months prior to the date of the audiologic evaluation.

Audiometric testing must be completed in a sound-treated booth or room

Word recognition testing for a person not fluent in English should be conducted in the language that the person is most fluent, using an appropriate word list for the language for which they are most fluent. For non-recorded testing, the professional conducting the test should also be fluent in the language utilized for the test.

The HINT is specified as the “accepted standard for assessing hearing outcome after cochlear implantation” and those versions normed for children as young as age 6 can be utilized in those aged 5-6 and with adults with literacy problems.